Entries for October 2008

How fitting that in these cost-conscious times, some experts are questioning whether pricey new diabetes drugs like Actos and Byetta actually provide more bang for the buck than older, cheaper ones. Their research dovetails nicely with new diabetes treatment guidelines that support trying less expensive drugs to lower blood sugar levels first and only moving on to more expensive drugs if the cheaper ones don't do the trick.

Researchers at Stanford University and the University of Chicago reported that spending on diabetes drugs nearly doubled between 2001 and 2007, to $12.5 billion. They concluded that the use of newer diabetes drugs was largely responsible for the rise in the mean cost per prescription from $56 in 2001 to $76 in 2007. More patients also received prescriptions for more than one medication. In 1994, 82 percent of patients took just one drug; by 2007, that number had dropped to just 47 percent.

Is the prospect of getting a colonoscopy less dreadful if you know you'll be knocked unconscious during the big event? The majority of patients in a small survey said yes, but some experts argue that it's the pre-procedure bowel cleansing that generally makes people put off getting the test, not the screening itself.

Whichever it is, removing barriers to screening is important. Even though colorectal cancer screening is recommended for people starting at age 50 and every 10 years thereafter, only about half of people who should be screened get the test. As I've written before, roughly half of states require insurance companies to cover colon cancer screening, whose cost generally ranges from about $1,000 to $3,000.

Figuring out how to get the best care at a reasonable cost through a consumer-driven health plan takes practice, and doctors are often just as confused as their patients. If you're accustomed to simply deferring to your doctor's medical expertise, you may need to be more assertive about managing your care if you want to keep costs under control, new research suggests.

A "consumer driven" plan typically refers to a health insurance policy with a deductible of at least $1,000 that has some sort of financial account (like a health savings account) attached to it into which the consumer, the employer, or both can deposit money to pay for medical expenses. Because of that high deductible, patients may be responsible for paying for doctor visits, lab work, diagnostic imaging, drugs, and other medical expenses that would be covered under a traditional plan, at least until they reach the deductible. (Even if your plan doesn't qualify as "consumer driven," chances are you're paying more out of pocket every year, so these issues may concern you, too.) Some 13 percent of companies that offer health insurance have such plans now, but they're spreading: About a quarter of employers say they're at least somewhat likely to offer one next year, according to the Kaiser Family Foundation.